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Janssens O, Haerens L, Valcke M, Embo M, Debacker J, Van Hecke A, Gauwe V, Van Hecke M, De Vriendt P, Pype P. The development of a research-based interprofessional communication behaviors repository in healthcare education: A systematic review. J Interprof Care 2024:1-18. [PMID: 39074503 DOI: 10.1080/13561820.2024.2372017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 03/23/2024] [Accepted: 06/18/2024] [Indexed: 07/31/2024]
Abstract
Interprofessional communication is crucial for patient care, yet there is a dearth of comprehensive assessment tools essential to train and assess healthcare students. While the Interprofessional Educational Collaborative framework (IPEC) outlines eight sub-competencies, it lacks detailed behavioral indicators. This study aimed to create a repository of interprofessional communication behaviors to complement the IPEC sub-competencies. From 12,448 articles, 55 were selected and thematically analyzed with NVivo18®. We identified 230 interprofessional communication behaviors, organized into 10 themes and 61 sub-themes, aligning with the IPEC sub-competencies. This comprehensive repository could be foundational for developing interprofessional communication assessment tools in healthcare education and aiding healthcare institutions in improving interprofessional communication practices.
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Affiliation(s)
- Oona Janssens
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Mieke Embo
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
- Department of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium
| | - Jens Debacker
- Vrije Universiteit Brussel (VUB),Molecular Imaging and Therapy Research Group (MITH), Brussels, Belgium
- Department of Nuclear Medicine, Vrije Universiteit Brussel (VUB),University Hospital Brussels (UZ Brussel), Brussels, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Vanessa Gauwe
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Marlies Van Hecke
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Patricia De Vriendt
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
- Frailty in Ageing (FRIA) research group, Mental Health and Wellbeing research group (MENT), Gerontology department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
| | - Peter Pype
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Centre for Interprofessional Collaboration in Education, Research and Practice, Ghent University, Ghent, Belgium
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Brogaard L, Rosvig L, Hjorth-Hansen KR, Hvidman L, Hinshaw K, Kierkegaard O, Uldbjerg N, Manser T. Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams. Front Med (Lausanne) 2024; 11:1330457. [PMID: 38572162 PMCID: PMC10987771 DOI: 10.3389/fmed.2024.1330457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/12/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Vacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician's technical abilities (1-3). Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions. Methods We installed between two or three video cameras in each delivery room at Aarhus University Hospital and Horsens Regional Hospital and obtained 60 videos of teams managing vacuum extraction. Appropriate consent was obtained. Two raters carefully reviewed the videos and assessed the teams' non-technical skills using the Assessment of Obstetric Team Performance (AOTP) checklist, rating all items on a Likert scale score from 1 to 5 (1 = poor; 3 = average; and 5 = excellent). This resulted in a total score ranging from 18 to 90. Two different raters independently assessed the teams' clinical performance (adherence to clinical guidelines) using the TeamOBS-Vacuum-Assisted Delivery (VAD) checklist, rating each item (0 = not done, 1 = done incorrectly; and 2 = done correctly). This resulted in a total score with the following ranges (low clinical performance: 0-59; average: 60-84; and high: 85-100). Interrater agreement was analyzed using intraclass correlation (ICC), and the risk of high or low clinical performance was analyzed on a logit scale to meet the assumption of normality. Results Teams that received excellent non-technical scores had an 81% probability of achieving high clinical performance, whereas this probability was only 12% among teams with average non-technical scores (p < 0.001). Teams with a high clinical performance often had excellent behavior in the non-technical items of "team interaction," "anticipation," "avoidance fixation," and "focused communication." Teams with a low or average clinical performance often neglected to consider analgesia, had delayed abandonment of the attempted vaginal delivery and insufficient use of appropriate fetal monitoring. Interrater reliability was high for both rater-teams, with an ICC for the non-technical skills of 0.83 (95% confidence interval [CI]: 0.71-0.88) and 0.84 for the clinical performance (95% CI: 0.74-0.90). Conclusion Although assisted vaginal delivery by vacuum extraction is generally considered to be an operator-dependent task, our findings suggest that teamwork and effective team interaction play crucial roles in achieving high clinical performance. Teamwork helped the consultant anticipate the next step, avoid fixation, ensure adequate analgesia, and maintain thorough fetal monitoring during delivery.
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Affiliation(s)
- L. Brogaard
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - L. Rosvig
- Department of Obstetrics and Gynecology, Randers Hospital, Randers, Denmark
| | | | - L. Hvidman
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - K. Hinshaw
- Department of Obstetrics and Gynecology, Sunderland Royal Hospital, Sunderland, United Kingdom
| | - O. Kierkegaard
- Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark
| | - N. Uldbjerg
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - T. Manser
- FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
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Janssens O, Embo M, Valcke M, Haerens L. When theory beats practice: the implementation of competency-based education at healthcare workplaces : Focus group interviews with students, mentors, and educators of six healthcare disciplines. BMC MEDICAL EDUCATION 2023; 23:484. [PMID: 37386406 DOI: 10.1186/s12909-023-04446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/13/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Work-integrated learning constitutes a large part of current healthcare education. During the last decades, a competency-based educational (CBE) approach has been introduced to reduce the theory-practice gap and to promote continuous competency development. Different frameworks and models have been developed to support CBE implementation in practice. Although CBE is now well-established, implementation at healthcare workplaces remains complex and controversial. This study aims to explore how students, mentors, and educators from different healthcare disciplines perceive the implementation of CBE at the workplace. The six-step model of Embo et al. (2015) was used as a base: (1) competency selection, (2) formulating learning goals, (3) self-monitoring performance, (4) self-assessing competency development, (5) summative assessment of individual competencies, and (6) summative assessment of global professional competence. METHODS Three semi-structured focus group interviews were conducted with (1) five students, (2) five mentors, and (3) five educators. We recruited participants from six different educational programs: audiology, midwifery, nursing (associate degree and bachelor), occupational therapy, or speech therapy. We used thematic analysis combining an inductive and deductive approach. RESULTS An overview of the predefined competencies was hard to find which complicated CBE implementation and resulted in a lack of consistency between the steps; e.g., the link between the selection of relevant competencies (step 1) and the formulation of learning goals based on these selected competencies (step 2) was absent. Furthermore, the analysis of the data helped identifying seven barriers for CBE implementation: (1) a gap between the educational program and the workplace, (2) a lacking overview of predefined competencies, (3) a major focus on technical competencies at the expense of generic competencies, (4) weak formulation of the learning goals, (5) obstacles related to reflection, (6) low feedback quality, and (7) perceived subjectivity of the assessment approach. CONCLUSION The present barriers to CBE implementation lead to a fragmentation of current work-integrated learning. In this way, theory beats practice when it comes to CBE implementation as the theory of CBE is not effectively implemented. However, the identification of these barriers might help to find solutions to optimize CBE implementation. Future research seems critical to optimize CBE so that theory can meet practice and the opportunities of CBE optimize healthcare education.
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Affiliation(s)
- Oona Janssens
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium.
| | - Mieke Embo
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Voetweg 66, Ghent, 9000, Belgium
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium
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Ghafili A, Gantare A, Lobet-Maris C, Gourdin M. Towards the Elaboration of a Non-Technical Skills Development Model for Midwives in Morocco. Healthcare (Basel) 2022; 10:healthcare10091683. [PMID: 36141295 PMCID: PMC9498369 DOI: 10.3390/healthcare10091683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
This article explores the non-technical skills critical for the practice of midwives through a comparison of two maternity services in Morocco. Soft skills, or non-technical skills, present a set of metacognitive abilities, which complement hard or technical skills, in order to guarantee the safe performance of a technical activity. This exploration is based on an original methodology that triangulates observation of caring paths, qualitative interviews, and quantitative questionnaires. We identified the main soft skills mastered, those that were missing, and those to be developed, based on an observed or expressed need. The research population included 30 midwives and 70 women. The results led us to identify the most critical non-technical skills for midwifery practice at a Local Medical Centre (LMC) and a Provincial Hospital Centre (PHC) to better understand the effects of workload on the possibilities of activating non-technical skills during caring paths. Based on these results, we elaborated a model for the development and improvement of non-technical skills in midwifery.
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Affiliation(s)
- Asmaa Ghafili
- Nursing and Midwifery Unit, Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
- Faculty of Public Health, Université Catholique de Louvain, 1200 Woluwe-Saint-Lambert, Belgium
- Correspondence:
| | - Abdellah Gantare
- Nursing and Midwifery Unit, Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Claire Lobet-Maris
- Royal Academy of Science, Letters and Fine Arts of Belgium, BE1000 Bruxelles, Belgium
- Technology, Ethics & Society Research Unit, Research Centre in Information, Law and Society (CRIDS), Namur Digital Institute (NADI), Faculty of Computer Sciences, University of Namur, 5000 Namur, Belgium
| | - Maximilien Gourdin
- Faculty of Public Health, Université Catholique de Louvain, 1200 Woluwe-Saint-Lambert, Belgium
- Department of Anesthesiology, UCLouvain, CHU UCL Namur, 5530 Namur, Belgium
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Baxendale B, Evans K, Cowley A, Bramley L, Miles G, Ross A, Dring E, Cooper J. GENESISS 1-Generating Standards for In-Situ Simulation project: a scoping review and conceptual model. BMC MEDICAL EDUCATION 2022; 22:479. [PMID: 35725432 PMCID: PMC9208746 DOI: 10.1186/s12909-022-03490-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/23/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND In-Situ Simulation (ISS) enables teams to rehearse and review practice in the clinical environment to facilitate knowledge transition, reflection and safe learning. There is increasing use of ISS in healthcare organisations for which patient safety and quality improvement are key drivers. However, the effectiveness of ISS interventions has not yet been fully demonstrated and requires further study to maximise impact. Cohesive programmatic implementation is lacking and efforts to standardise ISS terms and concepts, strengthen the evidence base and develop an integrated model of learning is required. The aim of this study was to explore the current evidence, theories and concepts associated with ISS across all areas of healthcare and develop a conceptual model to inform future ISS research and best practice guidance. METHODS A scoping review was undertaken with stakeholder feedback to develop a conceptual model for ISS. Medline, OpenGrey and Web of Science were searched in September 2018 and updated in December 2020. Data from the included scoping review studies were analysed descriptively and organised into categories based on the different motivations, concepts and theoretical approaches for ISS. Categories and concepts were further refined through accessing stakeholder feedback. RESULTS Thirty-eight papers were included in the scoping review. Papers reported the development and evaluation of ISS interventions. Stakeholder groups highlighted situations where ISS could be suitable to improve care and outcomes and identified contextual and practical factors for implementation. A conceptual model of ISS was developed which was organised into four themes: 1. To understand and explore why systematic events occur in complex settings; 2.To design and test new clinical spaces, equipment, information technologies and procedures; 3. To practice and develop capability in individual and team performance; 4. To assess competency in complex clinical settings. CONCLUSIONS ISS presents a promising approach to improve individual and team capabilities and system performance and address the 'practice-theory gap'. However, there are limitations associated with ISS such as the impact on the clinical setting and service provision, the reliance of having an open learning culture and availability of relevant expertise. ISS should be introduced with due consideration of the specific objectives and learning needs it is proposed to address. Effectiveness of ISS has not yet been established and further research is required to evaluate and disseminate the findings of ISS interventions.
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Affiliation(s)
- Bryn Baxendale
- Trent Simulation & Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, Notts UK
| | - Kerry Evans
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Alison Cowley
- Nottingham University Hospitals NHS Trust, Research and Innovation, Nottingham, UK
| | - Louise Bramley
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Guilia Miles
- Trent Simulation & Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, Notts UK
| | - Alastair Ross
- Glasgow Dental School, University of Glasgow, Glasgow, UK
| | - Eleanore Dring
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Joanne Cooper
- Institute of Care Excellence, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Perera A, Griffiths R, Myers JA. Integrative Review of Non-Technical Skills Frameworks to Apply for Air Medical Transfer of Pregnant Women. J Obstet Gynecol Neonatal Nurs 2022; 51:257-277. [PMID: 35278350 DOI: 10.1016/j.jogn.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To identify the most suitable non-technical skills framework to adapt and apply to the air medical transfer of pregnant women. DATA SOURCES Embase, PsycINFO, PubMed, MEDLINE, Web of Science, CINAHL, Science Direct, and Google Scholar. STUDY SELECTION We retrieved potentially relevant articles using a predefined combination of keywords extended with truncation and Boolean operators. Database and manual reference searches yielded 569 peer-reviewed articles. We included articles if they presented empirical data and described non-technical or cognitive competency skills frameworks for health care professionals. We discussed any ambiguities regarding inclusion, and they were resolved by consensus. We retained 71 full-text articles for final review. DATA EXTRACTION We coded extracted data under four criteria: non-technical skill categories, context of use, psychometric properties, and rating system. We generated descriptive summary tables of the characteristics of existing non-technical skills frameworks based on publication year, method of development, clinical setting, clinical specialty, routine/crisis-based performance, and team/individual performance. DATA SYNTHESIS We identified 42 non-technical skills frameworks from a variety of health care settings. We critically examined context of use and how use in various clinical settings may align with air transfers of pregnant women. Our findings illustrate the importance of team-based and routine performance rather than crisis-focused skills. Maintaining situational awareness throughout all stages of the transfer and communicating effectively with team members, the pregnant woman, and her partner are skills that are particularly important to ensure good outcomes. CONCLUSION We selected the Global Assessment of Obstetric Team Performance as the most suitable non-technical skills framework to adapt to the clinical setting of air medical transfer of pregnant women. We considered the clinical specialty, specific non-technical skills required in the setting, the framework's properties, and the requirement to focus on routine team performance.
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Reliability Evaluation of the Factors That Influenced COVID-19 Patients’ Condition. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11062589] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Health and safety is a problem that is intensively discussed nowadays. The failures in healthcare are called medical errors: if the patient’s condition worsens or he/she contracts an illness, then the actions that led to this are interpreted as medical errors. Medical errors can be the result of new procedures, extremes of age, complex or urgent care, improper documentation, illegible hand-writing, or patient actions. One of the ways to reduce medical error is an evaluation of its possibility, and then using the result of this evaluation to improve the medical organization units and processes in patient diagnosis, treatment, and care. This evaluation is possible based on methods of reliability engineering. The reliability engineering methods allow evaluating of different systems’ reliability and the influence of external and internal factors on system reliability. These methods’ application needs the system to be investigated or objective interpretation in terms of reliability engineering. Therefore, such a system in healthcare, for the diagnosis of disease, a patient’s treatment, the influence of different factors on a patient’s condition, and others, should be presented according to the rules and demands of reliability engineering. The first step is development of the mathematical representation of the investigated system or object according to the demands of the reliability analysis. One of the often-used mathematical representations in the reliability analysis of a system is the structure function. However, this mathematical representation needs completely specified initial data. The initial data from the healthcare domain for medical error analysis is uncertain and incompletely specified. Therefore, the development of this mathematical representation needs special methods. In this paper, a new method for the mathematical representation of system development based on uncertain and incompletely specified data is proposed. The system evaluation based on the structure function allows computing of many reliability indices and measures used in reliability engineering. The approbation of this method is considered based on an example of COVID-19 patients.
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Cheloufi M, Picard J, Hoffmann P, Bosson JL, Allenet B, Berveiller P, Albaladejo P. How to agree on what is fundamental to optimal teamwork performance in a situation of postpartum hemorrhage? A multidisciplinary Delphi French study to develop the Obstetric Team Performance Assessment Scale (OTPA Scale). Eur J Obstet Gynecol Reprod Biol 2020; 256:6-16. [PMID: 33161212 DOI: 10.1016/j.ejogrb.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The objective of this study was to develop a new interdisciplinary teamwork scale, the Obstetric Team Performance Assessment (OTPA), for the management of the post-partum hemorrhage, through consensus agreement of obstetric caregivers. The goal is to provide a reliable tool for teaching and evaluating teams in high-fidelity simulation. METHODS This prospective study is based on an expert consensus, using a Delphi method. The authors developed the "OTPA» specifically related to the management of post-partum hemorrhage, using existing recommendations. For the Delphi survey, the scale was distributed to a selected group of experts. After each round of Delphi, authors quantitatively analyzed each element of the scale, based on the percentages of agreement received, and reviewed each comment. This blind examination then led to the modification of the scale. The rounds were continued until 80-100 % agreement with a median overall response score equal to or greater than 8 was obtained for at least 60 % of items. Repeated 3 times, the process led to consensus and to a final version of the OTPA scale. RESULTS From February to October 2018, 16 of the 33 invited experts participated in four Delphi cycles. Of the 37 items selected in the first round, only 19 (51.3 %) had an agreement of 80-100% with a median overall response score equal to or greater than 8 in the second round, and a third round was conducted. During this third round, 24 of the 37 items were validated (64.9 %) and 82 of the 88 sub-items obtained 80 %-100 % agreement (93.2 %). The fourth round consisted of proposing a weighting of the different items. CONCLUSION Using a structured Delphi method, we provided a new interdisciplinary teamwork scale (OTPA), for the management of the post-partum hemorrhage. Thus, this scale will be able to be used during high-fidelity scenarii to assess performances of various teams facing a scenari of PPH. Moreover, this scale, focusing some crucial aspects of interdisciplinary teamwork will be useful for teaching purpose.
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Affiliation(s)
- Meryam Cheloufi
- Department of Obstetrics and Gynecology, Armand Trousseau Children's Hospital, AP-HP, Paris, France.
| | - Julien Picard
- Department of Anesthesia and Critical Care, Simulation Center, Grenoble Alps University Hospital, Grenoble, France; TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
| | - Pascale Hoffmann
- Department of Obstetrics and Gynecology, Armand Trousseau Children's Hospital, AP-HP, Paris, France
| | - Jean-Luc Bosson
- TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
| | - Benoit Allenet
- TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
| | - Paul Berveiller
- Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France
| | - Pierre Albaladejo
- Department of Anesthesia and Critical Care, Simulation Center, Grenoble Alps University Hospital, Grenoble, France; TheMAS, TIMC, UMR-CNRS 5525, Clinical Investigation Center, Grenoble Alps University Hospital, Grenoble, France
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Benefits of Screen-Based Postpartum Hemorrhage Simulation on Nontechnical Skills Training: A Randomized Simulation Study. Simul Healthc 2020; 14:391-397. [PMID: 31804424 DOI: 10.1097/sih.0000000000000395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postpartum hemorrhage (PPH) is the leading cause of maternal death in the world. Nontechnical skills (NTS), such as communication and teamwork, are critical for efficient management of this obstetric emergency. Specific scenarios were designed on a screen-based simulator to train NTS. This study aimed to evaluate the impact of training midwives for NTS with a PPH screen-based simulation. METHODS A total of 24 midwives participated in the study. They were randomized in 2 groups: the NTS group (n = 12) performed 3 screen-based scenarios designed to train NTS and the control group (n = 12) performed 3 basic scenarios of the screen-based simulation without the NTS training. A structured interview followed the simulation. On the same day, each trainee underwent individually an evaluation on a PPH high-fidelity simulation scenario. Three experts, blinded to the study arm, assessed the NTS with the Anesthetists Non-Technical Skills (ANTS) score. RESULTS Midwives from the NTS group achieved higher median scores in each dimension of the ANTS score: task management (4 vs. 2/4, P < 0.0001), team working (4 vs. 2/4, P < 0.0001), situation awareness (4 vs. 2.7/4, P < 0.0001), and decision-making (4 vs. 2/4, P < 0.0001). The median value of the total ANTS score was higher in the NTS group than in the control group (15.5 vs. 8/16, P < 0.0001). CONCLUSIONS Our study highlights that training with a NTS screen-based simulation, with specific scenarios and debriefing, leads to higher midwives' nontechnical skills performance during simulated postpartum hemorrhage.
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Higham H, Greig PR, Rutherford J, Vincent L, Young D, Vincent C. Observer-based tools for non-technical skills assessment in simulated and real clinical environments in healthcare: a systematic review. BMJ Qual Saf 2019; 28:672-686. [DOI: 10.1136/bmjqs-2018-008565] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 12/18/2022]
Abstract
BackgroundOver the past three decades multiple tools have been developed for the assessment of non-technical skills (NTS) in healthcare. This study was designed primarily to analyse how they have been designed and tested but also to consider guidance on how to select them.ObjectivesTo analyse the context of use, method of development, evidence of validity (including reliability) and usability of tools for the observer-based assessment of NTS in healthcare.DesignSystematic review.Data sourcesSearch of electronic resources, including PubMed, Embase, CINAHL, ERIC, PsycNet, Scopus, Google Scholar and Web of Science. Additional records identified through searching grey literature (OpenGrey, ProQuest, AHRQ, King’s Fund, Health Foundation).Study selectionStudies of observer-based tools for NTS assessment in healthcare professionals (or undergraduates) were included if they: were available in English; published between January 1990 and March 2018; assessed two or more NTS; were designed for simulated or real clinical settings and had provided evidence of validity plus or minus usability. 11,101 articles were identified. After limits were applied, 576 were retrieved for evaluation and 118 articles included in this review.ResultsOne hundred and eighteen studies describing 76 tools for assessment of NTS in healthcare met the eligibility criteria. There was substantial variation in the method of design of the tools and the extent of validity, and usability testing. There was considerable overlap in the skills assessed, and the contexts of use of the tools.ConclusionThis study suggests a need for rationalisation and standardisation of the way we assess NTS in healthcare and greater consistency in how tools are developed and deployed.
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Hamilton AL, Kerins J, MacCrossan MA, Tallentire VR. Medical Students’ Non-Technical Skills (Medi-StuNTS): preliminary work developing a behavioural marker system for the non-technical skills of medical students in acute care. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2018; 5:130-139. [DOI: 10.1136/bmjstel-2018-000310] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 12/15/2022]
Abstract
IntroductionGood non-technical skills (NTS) are critical to the delivery of high-quality patient care. It is increasingly recognised that training in such skills should be incorporated into primary medical training curricula. This study aimed to develop an NTS behavioural marker system (BMS), specifically applicable to medical students, for use within simulated acute care scenarios.MethodsThe methodology used to develop other BMS was adopted and modified. Following ethical approval, 16 final year medical students participated in acute care simulated scenarios. Semistructured interviews were performed to gauge the understanding of NTS. A panel meeting of subject matter experts was convened to translate key NTS into skill elements and observable behaviours. A second expert panel was consulted to refine aspects of the BMS. Further refinement and initial face validity was undertaken by a third panel of experts using the prototype BMS to observe prerecorded simulation scenarios.ResultsFive categories of NTS were identified: situation awareness, teamwork and communication, decision-making and prioritisation, self-awareness, and escalating care. Observable behaviours in each category describe good and poor performance. Escalating care was identified as a unique component that incorporated behaviours related to each of the other four skill categories. A 5-point rating scale was developed to enable both peer-to-peer and tutor-to–student feedback.ConclusionThe Medi-StuNTS (Medical Students’ Non-Technical Skills) system is the first BMS for the NTS of medical students. It reinforces the importance of escalating care effectively. It provides an exciting opportunity to provide feedback to medical students and may ultimately aid their preparedness for professional practice.
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Crisis Resource Management in the Delivery Room: Development of Behavioral Markers for Team Performance in Emergency Simulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030439. [PMID: 29510491 PMCID: PMC5876984 DOI: 10.3390/ijerph15030439] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/21/2018] [Accepted: 02/27/2018] [Indexed: 11/28/2022]
Abstract
Human factors are the most relevant issues contributing to adverse events in obstetrics. Specific training of Crisis Resource Management (CRM) skills (i.e., problem solving and team management, resource allocation, awareness of environment, and dynamic decision-making) is now widespread and is often based on High Fidelity Simulation. In order to be used as a guideline in simulated scenarios, CRM skills need to be mapped to specific and observable behavioral markers. For this purpose, we developed a set of observable behaviors related to the main elements of CRM in the delivery room. The observational tool was then adopted in a two-days seminar on obstetric hemorrhage where teams working in obstetric wards of six Italian hospitals took part in simulations. The tool was used as a guide for the debriefing and as a peer-to-peer feedback. It was then rated for its usefulness in facilitating the reflection upon one’s own behavior, its ease of use, and its usefulness for the peer-to-peer feedback. The ratings were positive, with a median of 4 on a 5-point scale. The CRM observational tool has therefore been well-received and presents a promising level of inter-rater agreement. We believe the tool could have value in facilitating debriefing and in the peer-to-peer feedback.
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